Obstructive sleep apnoea

Question 1

What causes OSA?

Answer 1

Collapse of the pharyngeal airway while sleeping

Question 2

Presentation of OSA?

Answer 2

Morning headaches

Apnoeic episodes - usually reported by the partner

Snoring

Waking up feeling unrefreshed from sleep

Daytime sleepiness and concentration problems

Question 3

Risk factors for OSA?

Answer 3

Middle age
Male
Obesity
Alcohol
Smoking

Question 4

Causes of headaches worse in the morning include…

Answer 4

OSA

Raised ICP - but these tend to also present with worsening on bending down

Question 5

Complications of OSA

Answer 5

Severe cases can cause hypertension, heart failure and can increase the risk of myocardial infarction and stroke

Question 6

What scale can be used to assess OSA?

Answer 6

Epworth sleep scale - used to assess symptoms of sleepiness associated with OSA

Question 7

Investigations in suspected OSA

Answer 7

Refer to ENT or specialist sleep clinic for sleep studies

Blood tests - FBC (?anaemia), U&Es

Question 8

Management of OSA

Answer 8

Correct reversible RFs:

• Lose weight
• Stop drinking alcohol
• Stop smoking

CPAP is the next step

Surgery is another option - involves quite significant surgical restructuring of the soft palate and jaw. The most common procedure is called uvulopalatopharyngoplasty (UPPP).